REVISED December 6, 2018 Land Use Meeting Agenda Item #5

Subject Planning Commission - This item to be heard after all other items on agenda Briefings Briefing Provided Upon Request Contact and/or Presenter Information

Presenter:

John Barnott, Director, 941-748-4501 ext. 3887

Contact:

Bobbi Roy, Senior Planning & Zoning Technician

941-748-4501 ext. 6878

Action Requested

Please appoint three people to the Planning Commission Advisory Board.

Enabling/Regulating Authority

Florida Statutes

Manatee County Comprehensive Plan

Manatee County Land Development Code

Background Discussion

● There are three vacancies on the Planning Commission. ● Mr. DeLesline is seeking reappointment and his seat would expire in 2022. ● One of the remaining seats expires in 2021 the other in 2022. ● The following people have submitted applications for the Planning Commission Advisory Board:

❍ James P. Adkins ❍ Amanda Barbee

Manatee County Government Administrative BuildingFirst Floor, Patricia M. Glass Chambers

9:00 am - December 6, 2018

❍ Mark D. Black ❍ Matthew J. Bower ❍ Kent N. Brown ❍ Richard A. Buchanan ❍ Craig Copeman ❍ Jonathan B. Crane ❍ Peter G. DeAngelis ❍ John DeLesline (Current Member) ❍ Steve Dennis ❍ Glen Gibellina ❍ Shelley Hamilton ❍ Howard Hammerman ❍ Jedd W. Heap, AIA ❍ John E. Howell ❍ Gregory Lowell Janssen ❍ John T. Kleban ❍ Lillian Fay Lipson ❍ Pete G. Peters ❍ John L. Simon ❍ William W. Smock ❍ Andrea L. Suarez ❍ Jason B. Taylor

County Attorney Review Not Reviewed (No apparent legal issues) Explanation of Other Reviewing Attorney N/A Instructions to Board Records N/A Cost and Funds Source Account Number and Name N/A Amount and Frequency of Recurring Costs N/A Attachment: 2018 Applications compiled.pdf Attachment: Candidate Matrix 2018.pdf Attachment: Current Membership Roster.pdf

Manatee County Government Administrative BuildingFirst Floor, Patricia M. Glass Chambers

9:00 am - December 6, 2018

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700 Bradenton, FL 34205 Fax: (941) 745-3790 www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

Application Form 2016 2

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity Haven

.L. andall FoundationEarly Learning Coalition of Manatee County Easter Seals of S FloridaEducational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources Feeding Empty Little TummiesFoundation for Dreams Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus of Manatee Myakka City Community Center Pace Center for Girls Palmetto Youth Center Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah Freedom, Inc.Tallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children s Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 2017 5

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 2016 1

MANATEE COUNTYBOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700Bradenton, FL 34205 Fax: (941) 745-3790www.mymanatee.org/advisory_boards

APPLICATION forADVISORY BOARD/COMMITTEE/COMMISSION

PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions)

Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race

African American Asian American Caucasian

Hispanic American Native American Other _______________________

PLANNING COMMISSION

Amanda Barbee

4607 Arlington Rd4607 Arlington Rd

Palmetto, FL 34221678-372-3490 678-372-3490 678-372-3490Amanda@gauseandassociates.com

Landscape ArchitectGause and Associates, Inc

323 10th Ave W Suite 102Palmetto, FL 34221

Palmetto

Application Form 2016 2

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

None

None

I believe it is important for people to give back to their community. In this case, I have knowledgeand experience in local land planning and would like to be a part of encouraging the positivegrowth & development within Manatee County.

I have a degree in Landscape Architecture from The University of Georgia (2009) and currently workfor Gause and Associates, Inc. in Palmetto, Florida. I have 4 years of experience working with localagencies and developers within Manatee County and 5 years of experience within the State of Florida.

Bachelor of Landscape Architecture- UGA 2009CLARB- Council of Landscape Architectural Registration Board

Crosthwait Memorial Fishing Tournament Committee- Palmetto, FLManatee Chamber of Commerce- Project Teach & Big Bank Theory VolunteerAlliance of Therapy Dogs- Hospital Visits to Patients

Application Form 201 3

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Amanda Barbee 6-4-2018

Jonathan Davis Vice‐ Mayor City of Palmetto 

516 8th Ave W 

P.O. Box 1209 

Palmetto, FL 34220‐1209 

June 1, 2018 

Chair of Manatee County Commission 

Manatee County Planning Board Recommendation 

P.O. Box 1000  

Bradenton, FL 34206‐1000 

Honorable Board of County Commissioners : 

I would like to recommend for the Planning Board, Amanda Barbee. 

I feel that she would be a great asset as a planning board member, if we are to plan our future, we 

should be looking for youth, that would be willing to help plan for their county. 

I believe she has the skills needed to make informed decisions for the good of the county.  

Thank you for your consideration of Ms. Amanda Barbee  

Sincerely, 

Jonathan Davis Vice‐ Mayor City of Palmetto 

n6—iD4-.i8;08:22 ;ron:Edw&rd Jones Th:7453790 ;883851O37 # 2’ 4

MANATEE COUNIY(.-BOARD OF COUNTY COMM IthERS1112 Manatee Avenue West, Suite 902 JUN 2018 Phone: (941) 745-3700Bradenton, FL 34205 Fax: (941) 745-3790www. mymanatee.org/adviiory_boards

V..uilai .uu1ILy V •.

APPLICATION for /

ADVISORY BOARDICOMMITTEEICOMMISSIONPLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? - Name of Advisory Board:A separate application is required for each advisori

Planning Commision

Some advisory board positions have specific Please specify the seat you are interested in: V

requirements for applicants. For more information .

sonerplease click on this link to the Manatee County website anning ommis I

at: www.mymanatee. org/advisory_boards.

Name Matthew J BowerHome Street Address 3808 Bamboo TerraceHome Mailing Address

City, State, Zip Bradentori, FL 34210Home Phone 941761 3093 Work Phone 9416856683 Cell Phone 9413509224Email address clearbiue74@yahoo.comOccupation (if retired, please indicate) Financial Advisor, Edward JonesBusiness name Edward JonesBusiness street address 6402 Cortez Rd WCity, State, Zip radenton, FL 34210Are you registered to vote in Manatee County? Yes • No(This is a requirement of certain boards/commissions)

1 reside in County Commission District # 1 Q 2 0 3 € 4 0 5 0(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)Do you reside in unincorporated Manatee County? Yes No ThIf No, please indicate the CityThQ Board of County Commissioners strives to ensure equal access for minoritios and women to serve on advisory bo,rdslcommitteoslcommisaions.Pro’lding thLs lnforrrieuon will help Manatee County conipiio information needed to piy with theleoortinn r.xgilrpmen lnfIOIrJe Slate Statute_7GOO

Gender Male ® Female CRace

African American 0 Asian American Q Caucasian 0Hispanic American C Native American 0 Other 0

Board of County Commissioners

Applicjtion Form 2016 1

Ub-U4-1U:2 on’:dwara Jones Io:74537O ;a888510o37 3/ 4

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.None

Please list any Manatee County Advisory BoardslCommittees/Commissions on which you have previouslyserved (include dates of your service).Planning Commission Nov 201 320l 7

Why do you want to serve on this Advisory Bdard or Committee?Continue serving my community and helping to be a different voice and outlook to diversify theplanning board

Describe your education and experience that will provide a benefit to this Advisory Board.BA, St. Leo University (Business Admin), AAMS, and four years experience on the planningcommission.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.Series 7, 66, Florida 215 license, AAMS Designation and sunshine state law certifications.

List organizations and positions in which you serve in local civic or community groups.Manatee Tiger By the Bay Board; VP, Paws and Warriors; Suncoast JDRF; Florida HolocaustMuseum; and many others in various capacities.

Do you or your immediate family members have or hold any employment or contractual relationship withany business entity or agency which does business with or receives funding from Manatee CountyGovernment? Yes 0 No ® If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemedas a conflict of interest? Yes Q No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to servedue to job or travel? Yes Q No 0 If yes, please explain.

Application Form 2016 2

uuuC,JOL ,r’UL,UW(U UUH ,CD

BPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties andrequirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including avalid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds forremoval.4. Florida State Statute 119.07 designates this application as a public document to be made available foranyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on theapplication but you may include extra pages to provide additional information. Applications will not be processed unlesseach section has been completed and all supplemental information sought by County staff has been provided.Applicants will not be permitted to change information on their submitted application materials once they have beenreceived by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for theapplicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board — page 4Healthcare Advisory Board — page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applyingand certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. Iunderstand that I am offering my service without compensation. I agree to abide by all Manatee County Commissionrules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I furtherhereby acknowledge that should my professional, residential or other status change subsequent to my appointmentto this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to theextent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is trueand complete, and this constitutes my signature under the F ida lectronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address elow. Y may also fax or email your application, as follows:Mail: Board of County Commissioners Fax: 941-745-37901112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and thenATTN: Advisory Boards. attach it to an email. Email to this address:Bradenton, FL 34205

advisoryboards@mymanatee.orgThe Board of County Commissioners of Manatee County, Florida does not discriminate upon the basisof any individual’s disability status. This non-discrImination policy involves every aspect of theBoard’s functions including one’s access to, participation, employment, or treatment in its programsor activities. Anyone requiring reasonable accommodation for meetings as provided for in theAmericans with Disabilities Act should contact the CItizens Action Center, three days before a meetingat 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 3

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

Planning Commission

Craig Copeman

402 73 Street NW

Bradenton, FL 34209

941-920-7142CraigCopeman@gmail.com

Real Estate Sales

Keller Williams Manatee

4502 SR 64 East

Bradenton, FL 34208

Application Form 2016 2

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Citizens Oversight Tax Committee for Sales Tax

I believe my back ground in real estate representation throughout Manatee County gives me a clear understanding of the process in which our community development process is completed. I understand this Boards responsibility lies within the LDC and the interpretation of such to allow growth to take place as directed by the LDC.

Manatee High School graduate and attended Manatee Community College. Licensed Florida Real Estate Broker since 1978. Sold homes, businesses, developed land and have worked closely with the Planning Department for many years representing clients needs in relationship to the land developement code.

Licensed Florida Real Estate Broker, member of National, State, and Local Boards. Extensive construction and development experience. Life time resident of Manatee County

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.

2. Certain advisory boards, committees, and commissions have specific membership requirements including avalid voter registration card, financial disclosure and/or the submission of other information.

3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds forremoval.

4. Florida State Statute 119.07 designates this application as a public document to be made available foranyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the

extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs

or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Craig Copeman 5/12/2018

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity HavenD.L. Randall FoundationEarly Learning Coalition of Manatee County Easter Seals of SW FloridaEducational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources Feeding Empty Little TummiesFoundation for Dreams Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus of Manatee Myakka City Community Center Pace Center for Girls Palmetto Youth Center Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah Freedom, Inc.Tallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children's Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 2017 5

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

RECEIVED

MANATEE COUNTY SEP i4 2:i

BOARD OF COUNTY COMMISSIONERS ccJt:

1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700Bradenton, FL 34205 Fax: (941) 745-3790www.mymanatee.org/advisory_boards

APPLICATION forADVISORY BOARD/COMMITTEE/COMMISSION

PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? Name of Advisory Board:A separate application is required for each advisoryboard. ---q Ccmrni ssIOnSome advisory board positions have specific Please specify th&seat you are interested in:requirements for applicants. For more informationplease click on this link to the Manatee County websiteat: www.mymanatee.org/advisory_boards.

Name f3 ec , (Home Street Address inck cI rr@iHome Mailing Address

City, State,Zip ewoo Ra— FL,Home Phoneg.j Work Phone Cell Phone —

Email address I .

Qoi.i 1crr’

Occupation (if retired, please indicate)reA’ r e

Business name

Business street address

City, State, Zip

Are you registered to vote in Manatee County? Yes • No Q(This is a requirement of certain boards/commissions)

I reside in County Commission District # 1 Q 2 Q 3 0 4 0 5(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No QIf No, please indicate the City

________________________

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committeeslcommissions.Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.60.

Gender Males Female 0Race

African American Q Asian American 0 Caucasian •Hispanic American 0 Native American 0 Other 0

Application Form 2016 1

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee C.oIinty Advisory Boards/Committees/Commissions on which you have previously

served (include dates of your service).

-a(21/(o-)7

Why do you want to seThe on this Advisory Board or Committee?

6e1eDescribe your education and experience that will provide a benefit to this Advisory Board.

S\cr’ /t) Uvst d.YDV

Less-?\dList your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

i, rebrook V\oe Iko oe ôad- Ni-b’5 cor’

?evt5io strtrs opm)lCeDo you or your immediate family members have or hold any employment or contractual relationship with

any business entity or agency which does business with or receives funding from Manatee County

Government? Yes Q No • If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed

as a conflict of interest? Yes Q No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve

due to job or travel? Yes Q No • If yes, please explain.

Application Form 2016 2

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on theapplication but you may include extra pages to provide additional information. Applications will not be processed unlesseach section has been completed and all supplemental information sought by County staff has been provided.Applicants will not be permitted to change information on their submitted application materials once they have beenreceived by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for theapplicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board — page 4Healthcare Advisory Board — page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applyingand certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. Iunderstand that I am offering my service without compensation. I agree to abide by all Manatee County Commissionrules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I furtherhereby acknowledge that should my professional, residential or other status change subsequent to my appointmentto this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to theextent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is trueand complete, and this constitutes my signature under e Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. You may also fax or email your application, as follows:Mail: Board of County Commissioners Fax: 941-745-3790

1112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and thenATTN: Advisory Boards attach it to an email. Email to this address:Bradenton, FL 34205 advisoryboardsmymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basisof any individual’s disability status. This non-discrimination policy involves every aspect of theBoard’s functions including one’s access to, participation, employment, or treatment in its programsor activities. Anyone requiring reasonable accommodation for meetings as provided for in theAmericans with Disabilities Act should contact the Citizens Action Center, three days before a meetingat 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 3

Peter G. De Angelis

At age 27, I ran for and was elected to the Akron, Oho City Council. Akron had a

population of 300,000 and I represented 30,000.1 was assigned Chairman of the

Public Safety Committee, Vice Chairman of the Planning Committee and a

member of the Finance Committee. As the Vice Chair of the Planning my duty was

to provide the research needed for all the requests brought before the

Committee. This research involved all aspects of planning, zoning, rezoning and

Capital Improvement projects. As an example, Akron was one of the first cities in

the United States to receive funds through the Model Cities Program passed by

Congress. Our Committee became involved with the zoning (Residential

Commercial, Industrial), relocation, demolition and funding reports.

After serving for six years, I had an opportunity to purchase an Independent

Insurance Agency and did not run for reelection. As I neared retirement, I ran for

and was elected to the Tallmadge, Ohio City Council. Talimadge had a population

of 16,000 and I represented 4,000.1 was assigned to be the Chairman of the

Planning Committee and the Vice Chairman of the Finance Committee. In addition

to the regular duties of being Chair of the Planning Committee, I was instrumental

in drafting legislation for our Planned Unit Development (PUD). This is similar to

Manatee County’s Land Use Program. I also authored a comprehensive sign

ordinance and a comprehensive fence ordinance that has been used in other

cities. After serving for six years, I retired and moved to Florida.

If chosen, I believe my experience would be quite helpful to the Commission.

Having served both a large city and a small city, I have been involved in all aspects

of planning and zoning. I have the time and energy to be a devoted member.

Currently I am in my third year as a member of Manatee County’s Value

Adjustment Board. I am also a member of the Board of Directors of the

Greenbrook Village Association serving as the Treasurer. I also serve as the Chair

of the Modification Committee and am a member of the Restriction and Revisions

Committee.

Thank you for your consideration and if you have any questions or need

additional information I can be reached: By phone, 941 201 6487. By e-mail,

pgdeangelis@aol.com. By mail, 13416 Purple Finch Circle, Lakewood Ranch,

FL34242.

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Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms Design with community in mind

An experienced public sector planner, Ms. Hamilton's credentials include several positions with both Sarasota

County Planning Department and Manatee County Building and Land Development, and an additional seven

years with Wilson-Miller/Stantec. Her responsibilities have included the processing of rezone petitions, special

exception applications, and Comprehensive Plan Amendments. She is knowledgeable of all levels of

Comprehensive Plan, Zoning Ordinance, and Development Regulations, and offers an exceptional working

knowledge of the adopting Comprehensive Plan language relating to mixed-use developments and

affordable housing. Her three decade career acknowledges over 150 rezone petitions and another 160 special

exception applications.

EDUCATION

Associate of Arts, Secondary Education, Manatee

Community College, Bradenton, Florida, 1978

Bachelor of Science, Interdisciplinary Social

Sciences, University of South Florida, Tampa, Florida,

2006

MEMBERSHIPS

Board Member, Florida Planning and Zoning

Association

Member, American Planning Association

PROJECT EXPERIENCE

Planning

Miscellaneous Land Use/Development Projects,

Manatee County, Florida (Principal Planner)

Principal Planner for several projects providing support for

Land Use Entitlement, reports offering an analysis of the

highest and best use of property, or conceptual site planning

and engineering services. Projects included Myakka Gun

Range; numerous residential subdivisions including Long Bar

Pointe, Lake Flores, Southern Oaks;and McMullen Creek RV

Park (including Zoning Ordinance and Comprehensive Plan

policy changes to accompany this application); and several

controversial convenience store applications. Expertise with

the Manatee County Zoning Regulations and the Manatee

County Comprehensive Plan were needed to process all

applications.

As a Principal Planner, processed over 50 development

applications over a three year period. Responsibilities

included monitoring the applications through the review by

the Development Review Committee, preparation of the staff

analysis, we well as incorporating of all comments from the

Development Review Committee, and formulation of staff

report with recommended stipulations. As Principal Planner,

monitored the packet through the County Attorney’s Office

and ultimately through public hearings before the Planning

Commission and Board of County Commissioners. Served as

Interim Manager of Public Hearing Section, supervising all

Public Hearing planners through the same process.

Miscellaneous Land Use/Development Projects,

Sarasota County, Florida (Planner)

Planner for several projects providing support in a number of

different areas, including Land Use Entitlement Reports, a

Zoning Interpretation/Determination letters, reports offering

an analysis of the highest and best use of property, or

conceptual site planning and engineering services. Projects

included Out-of-Door Academy in Lakewood Ranch Corporate

Park, The Isles of Sarasota in Palmer Ranch, Palmer Ranch

Parcel B-10, Goodrich/Lemon Bay Parcel, Cattlemen

Road/Proctor Road Multi-Family development, Stickney Point

Road/U.S. 41 Mixed Use Project, and the Radisson Hotel on

North Cattlemen. Expertise with the Sarasota County Zoning

Regulations and Land Development Regulations, as well as

the Sarasota County Comprehensive Plan lends itself to the

direction of my time to these ventures.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

As a Project Planner, processed over 135 rezone petitions and

another 160 special exception applications through 21 years.

Responsibilities included monitoring the applications through

the review by the Development Review Committee,

preparation of the staff analysis, as well as incorporating of

all comments from the Development Review Committee, and

formulation of staff report with recommended stipulations. As

Project Planner, was also involved in the preparation of an

adopted ordinance and monitoring of the packet through the

review by the Planning Director, Office of the County Attorney

and County Administrator, and ultimately through public

hearings before the Planning Commission and Board of

County Commissioners.

Polo Club Special Events, Sarasota County, Florida

(Responsible Planner)

Responsible for the preparation and management of the

entitlement application to allow unlimited special events at the

Polo Club in Lakewood Ranch without the necessity of

obtaining a Temporary Use Permit each time that an event

was planned. Stantec prepared the Sarasota County Zoning

Ordinance amendment and then the special exception to allow

the special events in conjunction with Outdoor Recreational

Uses. The Zoning Ordinance was successfully processed

through the Planning Commission and Board of County

Commissioners, and following that, the special exception was

approved by both bodies, consistent with the new Zoning

Ordinance language.

Lowe’s on Palmer Ranch Parcel Q-1, Sarasota

County, Florida (Responsible Planner)

Responsible for the preparation and management of the

entitlement application to allow a 139,000 square foot Lowe’s

Home Center on 20 acres + in Increment III of the Palmer

Ranch Master Development, located on Central Sarasota

Parkway in Sarasota, Florida. Stantec prepared the

Notification of Proposed Change and the accompanying

rezone application and special exception applications to allow

the Lowe’s Home Center on the subject property. The

applications were approved by the Southwest Florida

Regional Planning Council and the Sarasota Board of County

Commissioners and contain conditions that ensure the

provision of 52% open space, the protection of the Catfish

Creek drainage area, and a reduced pervious area on the

property for the proposed Lowe’s retail outlet.

Glendening Multi-Family Project, Sarasota County,

Florida (Responsible Planner)

Responsible for the preparation and management of the

entitlement application to allow a multi-family rezoning of the

8.3 acres + located at the southeast corner of Honore Avenue

and DeSoto Road in north Sarasota County. Stantec prepared

the entitlement application to allow the development of up to

52 multi-family units on the subject property. The application

was approved, with stipulations, by the Board of County

Commissioners, providing for the ability for Stantec to

continue to provide the permitting support to obtain the site

and development approval to construct the multi-family

complex in the future.

Lake Village East and West, Sarasota, Florida

(Responsible Planner)

Responsible for the preparation and management of

entitlement application intended to compliment the Village on

the Trail mixed-use development. This rezone application of

this 27 acre + property, located east of S.R. 681 in Nokomis,

Florida, was approved to allow 92 residential dwelling units.

The property contains two separate parcels, the larger of

which is planned as a Cluster Housing subdivision, and the

small as a Planned Unit Development. Stantec has ensured

the unified development of both properties, in conjunction with

the Village on the Trail project, to ensure coordinated access,

landscape and amenities for all property owners.

Energy Efficiency Zone (EEZ), Sarasota, Florida

(Responsible Planner)

Responsible for the preparation and management of

entitlement application for a Comprehensive Plan Amendment

to designate 660 acres + located at S.R. 681 and future Honore

Avenue as a major employment center and commercial center

in southern Sarasota County. Stantec prepared the

entitlement application and has partnered with Sarasota

County In the processing of this property consistent with the

designation of the property as an Energy Economic Zone by

the state Department of Community Affairs. Following

approval of this Comprehensive Plan Amendment, Stantec will

continue to provide the future entitlement application and

permitting support in compliance with the Goals, Objectives

and Policies adopted as a part of the Comprehensive Plan

Amendment.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Venice Seaboard Master Plan, Sarasota County,

Florida (Planner)

Planner on the team assigned to research and analyze the

existing assets and potential land uses for the City of

Venice/Sarasota County Joint Participation Planning Study

for the area know as the Intercoastal Waterway

Industrial/U.S. 41 Corridor Area.

Clark Station Commercial Development, Sarasota

County, Florida (Planner Responsible)

Responsible for the preparation and management of the

entitlement application to allow a Transient Accommodation

to locate on the Clark Station Commercial project. Clark

Station is a multi-phased commercial project containing 11.66

acres located at the northwest corner of Clark Road and

Honore Avenue in north Sarasota County. Stantec prepared

the initial entitlement application and permitting support for

this property, the first phase of which consists of 45,000

square feet of office space on 4.66 acres of the property. This

project entailed the processing of a required special exception

through the Sarasota County Planning Department to allow

the transient accommodation in addition to the already-

approved commercial and office zoning on the property.

Stantec will continue to provide the permitting support for the

remaining development of the subject property in compliance

with the approved applications and conditions of approval.

In 2015, successfully prepared and managed of the entitlement

application to allow a Group Living Facility supporting 120

beds, also within the Clark Station Commercial Development.

Diocese of Venice Youth Retreat Center Ecological

Site Investigation, Sarasota County, Florida

(Planner)

Responsible for the preparation and management of the

entitlement application to allow a youth retreat center on the

42.6 acres + owned by the Diocese of Venice in southern

Sarasota County along the eastern site of the Myakka River.

Stantec prepared the entitlement application to allow the

youth retreat center which requires the processing of a special

exception through the Sarasota County Planning Department.

Development of the land is governed by an adopted ordinance

regulating development within a 220 foot wide protection

area ensuring protection of the Myakka River. Stantec will

continue to provide the permitting support in order to obtain

the final approval to allow the construction of the youth

retreat center in compliance with the approved special

exception application.

FPL DeSoto Solar Photovoltaic Next Generation

Facility, DeSoto County, Florida (Planner)

Planner for the preparation of entitlement application for the

1,525 acres + owned by Florida Power and Light in DeSoto

County. Stantec prepared the entitlement applications,

consisting of the Comprehensive Plan Amendment application

and special exception application necessary to allow a

megawatt solar photovoltaic (PV) generation facility on the

property. The Comprehensive Plan Amendment was

submitted to designate 5,162 acres of the land held by FPL as

an EGF (Electrical Generating Facility) to allow for future

development as a PV facility on the site. An environmental

evaluation of the site was provided, along with the phasing

and buffering plan.

Fox Creek, Sarasota, Florida (Project Planner)

Responsible for the preparation and management of the

applications for a Comprehensive Plan Amendment, an

amendment to the Fruitivlle Initiation, and a rezoning for the

property at the northeast corner of Richardson Road and

Wendel Kent Road. Stantec prepared the applications through

the Sarasota County Planning Department that entitlement of

465 residential units.

Marsh Cove, City of Bradenton, Florida (Project

Planner)

Worked with the Civil Engineer to prepared an application for

Marsh Cove, Phase II of a multi-family development within

the City of Bradenton. This application involved an

Amendment to an Approved RDP and allowed for 192 multi-

family units in Marsh Cove

Suncoast Community Church, Sarasota, Florida

(Project Planner)

Task Manager for the preparation and management of the

entitlement application to allow a Group Living Facility on the

81 acres + owned by the Suncoast Community Church in

Sarasota County. The Group Living Facility, if approved, will

contain 139 beds in a central facility and 58 free-standing

villas. The application will be processed as a rezone petition

and special exception through the Sarasota County Planning

Department. To date, the required pre-application meeting

with the Development Review Committee for Sarasota County

has been held, and the required Neighborhood Workshop is

scheduled. It is anticipated that the applications will be filled

after the first of the year in 2018.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Out-of-Door Academy, Sarasota, Florida (Project

Planner)

Task Manager for the preparation and management of an

application to reduce setbacks for the Out-of-Door Academy

on Siesta Key. The reduction of setbacks will be heard by the

Sarasota County Board of Zoning Appeals (BZA) and will

allow sun shade structures to be placed over playground

equipment and a drop-off/pick-up facility to protect the

students. This BZA hearing is scheduled for December 2017.

Regional and Community Planning

Sarasota Square Mall DRI, Sarasota, Florida

(Planner)

Responsible for preparation and management of annual

monitoring report for this 91 acre development containing a

regional shopping center at the intersection of U.S. 41 and

Beneva Road. Stantec prepared the Annual Monitoring

Report that was submitted to the Southwest Florida Regional

Planning Council and the state Department of Community

Affairs. This Annual Monitoring Report had not been

submitted for review for a six year period, so the effort was

big in order to pull together all the information from that six

year period and address compliance with the development

order conditions.

Myakka Pines Settlement, Sarasota County, Florida

(Planner)

Planner for preparation and management of entitlement

applications and permitting support for the 450 acres +

located in Englewood, Florida. Stantec prepared the rezone

application of the property to be developed as a Settlement, as

defined in the Sarasota County Comprehensive Plan. The

Settlement concept will create a compact development while

preserving large expanses of open space. Stantec will

continue to provide on-going permitting support for the

development, in coordination with Sarasota County staff to

ensure the implementation of the 2050 Village and Open Space

Resource Management Area of the Comprehensive Plan.

Lakewood Ranch Corporate Park, Sarasota

County, Florida (Responsible Planner)

Responsible for preparation and management of entitlement

application and annual monitoring for the 979 acre + parcel

located on University Parkway in North Sarasota County,

including 6,300,000 square feet of major employment center

uses, 24,000 square of accessory retail commercial uses, and

395 acres + of open space. Stantec prepared the original

applications and provides on-going permitting support for the

development, which is scheduled to occur over three phases

with a planned build-out in 2019. The project also entails the

bi-ennial monitoring of build-out of the project through

coordination with Sarasota County and the Southwest Florida

Regional Planning Council.

Sarasota County Interstate Business Center DRI,

Sarasota County, Florida (Responsible Planner)

Responsible for preparation and management of annual

monitoring report for this 251 acre development containing

major employment center, commercial and multi-family uses

at the intersection of Jacaranda Boulevard and I-75. Stantec

prepared the Annual Monitoring Report that was submitted to

the Southwest Florida Regional Planning Council and the

State Department of Community Affairs to demonstrate

compliance with the development order conditions.

Villages of Lakewood Ranch, Sarasota County,

Florida (Lead Planner)

Responsible for the oversight of preparation and management

of a wide spectrum of entitlement applications and permitting

support for the 4,000 acres + located in Sarasota County.

Stantec prepared the applications for the development as a

Village as defined in the Sarasota County Comprehensive

Plan, including the Comprehensive Plan, Development of

Regional Impact, and accompanying rezone application.

Stantec will continue to provide on-going biennial monitoring

and permitting support for the development, in coordination

with Sarasota County staff to ensure the implementation of

the 2050 Village and Open Space Resource Management Area

of the Comprehensive Plan. Since 2016, have processed four of

the required Neighborhood Plans (Neighborhood 2,

Neighborhoods 6 & 7, and Neighborhood 8) through to the

Neighborhood Plan submittals, and continued to aid the

Engineering teams to address questions during the Site and

Development/Subdivision process. Also, in 2016, began the

Biennial Monitoring process for the Villages of Lakewood

Ranch.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Village on the Trail DOCC, Sarasota County, Florida

(Planner)

Planner for preparation and management of entitlement

applications and permitting support for the 220 acre + mixed

use project located on S.R. 681 in Nokomis, Florida. Stantec

prepared the required processing and permitting services for

a Development of Critical Concern and the accompanying

rezoning. The project will be developed as a neo-traditional

mix of 1,950 residential units and 220,000 square feet of

retail/office and civic open space, and will incorporate the

“Rails-to-Trails” corridor in a regional planning effort. This

local DRI-level review is similar to that done at the State and

Regional level for DRI’s, utilizing a similar questionnaire and

review process used for larger developments. Stantec will

continue to provide on-going monitoring and permitting

support for the development, in coordination with Sarasota

County staff to ensure the implementation of the Development

of Critical Concern.

Indian Creek Hamlets, Sarasota County, Florida

(Planner)

Planner for the initial preparation of entitlement applications

and permitting support for the 4,000 acres + located in

eastern Sarasota County on Fruitville Road. Stantec prepared

the initial Development of Critical Concern application and

accompanying rezone application through the required

Neighborhood Workshop stage for this property to be

developed as a Hamlet, as defined in the Sarasota County

Comprehensive Plan. The applications have since been placed

in a hold status due to Transportation issues that need to be

worked out with Sarasota County. When processing is re-

established, the proposed Hamlet will be built in compliance

with the 2050 Village and Hope Space Resource Management

Areas of the Comprehensive Plan in order to create compact

development areas, while preserving large areas of open

space that surround the developed areas.

Palmer Ranch Master Development Plan*,

Sarasota, Florida

DRI Coordinator for the 5,119 acre development containing

10,500 dwelling units, 1,150,000 square feet of office uses,

400,000 square feet of retail uses, and 1,763,000 square feet

of industrial uses at build-out. The project was processed as a

Master Development to be ultimately built-out with 26

increments, requiring coordination with the Southwest

Florida Regional Planning Council and the State Department

of Community Affairs.

As a planner with Stantec, in 2016, processed an amendment

to the Palmer Ranch MDO to add property and units to allow

up to 14,200 dwelling units to the approved Palmer Ranch

Master Development. In addition to the update of the MDO,

processed two incremental changes, one to Increment IV to

allow the development of 140 residential dwelling units

(Promenade), and one within Increments XII/IV to allow an

access across a wetland area for a car dealership.

In 2017, successfully processed two additional applications

within Palmer Ranch; one to allow a 6,500 square foot

Community Center for the Palmer Ranch Master Homeowners

Association. The proposed Community Center is to be located

within Increment II. Also, prepared and processed Increment

XXVI, and the accompanying rezone application, to allow the

development of 400 residential dwelling units on one of the

last parcels in the Palmer Ranch MDO.

Tuscano DOCC*, Sarasota, Florida

DRI Coordinator for this project located on 2,500 acres in

southern Sarasota County on U.S. 41 between Englewood and

North Port. Responsible for the processing of the Development

of Critical Concern and the accompanying rezone application

to allow 1,750 dwelling units, a golf course and internal

amenities. Following the adoption of this project by the Board

of County Commissioners, as the DRI Coordinator for

Sarasota County, the review and approval of the subsequent

Annual Monitoring Reports, to ensure compliance with

adopted conditions of approval was my responsibility.

Stoneybrook at Venice DOCC*, Sarasota, Florida

DRI Coordinator for this local DRI-level analysis on the 750

acres + located in southern Sarasota County on South River

Road. Responsible for the processing of the Development of

Critical Concern and the accompanying rezone application to

allow 1,500 dwelling units, a golf course, and internal

amenities. Following the adoption of this project by the Board

of County Commissioners, as the DRI Coordinator for

Sarasota County, the review and approval of the subsequent

Annual Monitoring Reports, to ensure compliance with the

adopted conditions of approval was my responsibility.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Sarasota Interstate Park of Commerce DRI*, Florida

DRI Coordinator for the DRI and accompanying rezone

application for this 1,750,000 square foot mixed-use center at

the southwest quadrant of I-75 and University Parkway. This

regional level of review required coordination with the

Southwest Florida Regional Planning Council and the State

Department of Community Affairs. Following approval of this

project by the Board of County Commissioners, this project

required annual monitoring for compliance with the adopted

conditions of approval.

LT Ranch, Sarasota, Florida (Project Planner)

Coordinated the successful processing of a Development of

Critical Concern/Rezone application for the development of a

2050 Village for property located at the southeast intersection

of Clark Road and Bee Ridge Extension South. The

development included the provision of 3,250 dwelling units

and up to 300,000 square feet of retail/office using the

Village/Open Space regulations. This included the

coordination of all involved parties (engineering,

environmental, transportation, legal and the property

owners) to keep the project on track and to public hearings in

a timely manner.

Hi-Hat Ranch, Sarasota, Florida (Project Planner)

In 2017, began work on the future processing of the 10,000

acre + Hi-Hat Ranch property. The first task has been to

develop a procedure which can be used to process the

application through Sarasota County. Given the fact that the

DRI process is no longer an option with the State of Florida

Department of Economic Opportunity, Stantec is actively

working with Sarasota County to come up with a process to

apply to this property that will grant entitlements through a

Master Development Application (similar to the way Palmer

Ranch has proceeded through development) and allow for the

future processing of the Village Planned Development (VPD)

applications through a rezone application. At this point, we

are actively working with Sarasota County staff to come up

with the process that will adequately address all of staff’s

questions with the MDO application and process the

amendments necessary to the Comprehensive Plan and Zoning

Ordinance to recognize the new process that will be adopted in

the future.

Following the Comprehensive Plan and Zoning Ordinance

amendments, we will then proceed to filing of the applications

necessary to seek the entitlements that are envisioned by the

property owners.

Haval Farms Large Project, Manatee County,

Project Planner

Project Planner for the preparation of a Large Project

Application for this project that is to contain 3,842 dwelling

units on 1,280 acres + located at the Northwest corner of U.S.

301 and Moccasin Wallow Road in north Manatee County.

This application will be reviewed by Planning Staff and

proceed to Planning Commission and Board of County

Commissioners in Mid-Year 2018.

Villages of Amazon South, Large Project, Manatee

County, Project Planner

Project Planner for the preparation of a Large Project

Application for an amendment to an approved project

(Villages of Amazon South). This project will remove 233

acres + from the approved project, while retaining the

maximum entitlement of 1,999 dwelling units. The application

will result in a total of 1,046 acres + and a General

Development Plan that will regulate the remaining

development on the Villages of Amazon South property. The

required pre-application has been held with Manatee County

staff and the application is being completed for a submittal

before the end of 2017. The application will be reviewed by

Planning Staff and will then proceed to Planning Commission

and Board of County Commissioners in Mid-Year 2018.

Urban Regulations

Sarasota County Zoning Ordinance Amendments

for The Villages of Lakewood Ranch South,

Sarasota County, Florida (Responsible Planner)

Responsible for the processing of amendments to the Zoning

Regulations to allow the incremental processing of

Conservation Easements and PUD-type Modifications to a

Village submittal for the 4,000 acre + property located in

north Sarasota County. Stantec provided the language and

processing expertise to obtain approval for the amendments

from the Planning Commission and Board of County

Commissioners. This approval allowed for the continued

processing of The Villages of Lakewood Ranch South DRI

2050 Village.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Sarasota County Zoning Ordinance and Land

Development Regulations, Monitoring for Various

Clients, Sarasota County, Florida (Planner)

Continuous review and monitoring of changes to the Sarasota

County Zoning Ordinance and Land Development Regulations

that will be used to govern future development of client’s

properties, such as Schroeder-Manatee Ranch, Inc., Palmer

Ranch, and LT Ranch. This review and monitoring requires

coordination with Sarasota County staff and its consulting

teams to ensure the changes/amendments proposed will in no

case jeopardize the interests of Stantec clients.

Citrus County Public Works Manual Update and

Mining Ordinance Review, Citrus County, Florida

(Planner)

Planner for preparation and management of amendments to

the Transportation and Drainage Technical Manual for Citrus

County, as well as a technical review of the ordinance

controlling mining activities in Citrus County. The

Transportation Technical Manual includes roadway and

drainage standards to be included in the overall Land

Development Code for Citrus County, for use in developing

private and public projects. Stantec has provided input

ensuring compliance with the Zoning Regulations and

Comprehensive Plan. Final adoption of the mining ordinance

occurred in the Spring of 2009, while the final adoption of the

Transportation and Drainage Technical Manual is expected in

the Spring of 2011.

DeSoto Comprehensive Plan Update, DeSoto

County, Florida (Planner)

Planner for preparation and management of amendments to

change the DeSoto County’s Comprehensive Plan to provide

strategies and policies for greenhouse gas strategies and

carbon sequestration consistent with Florida House Bill 697.

Stantec provided policy input, ensuring several client’s

interests related to the development of the goals, policies and

objectives to be placed in the Comprehensive Plan. Following

review by the Department of Community Affairs, we have

continued to provide input in the ORC process to address

DCA’s concerns. Final adoption of the Comprehensive Plan

Amendment occurred in October, 2010.

Sarasota County Mixed-Use/ Affordable

Housing/Redevelopment Regulations*, Sarasota

County, Florida

Project Manager responsible for the development of Zoning

Ordinance and Land Development Regulations designed to

implement the adopted Comprehensive Plan policies relating

to mixed-use developments and affordable housing. These

regulations incorporated specific design regulations for all

developments of parcels of 10 acres or larger on properties

zoned CG (Commercial General) or designated for commercial

development or redevelopment. Led team of County planners,

private land-use planners and attorneys; and private,

concerned citizens. Responsible for drafting sections of the

code for the committee to review and then presenting all

proposed comments and edits to the Planning Commission

and the Board of County Commissioners for adoption.

Implementation of the Sarasota County Zoning

Ordinance*, Sarasota County, Florida

Responsible for researching the history of a zoning request

including why specific language was placed in the Zoning

Ordinance; prepared staff reports based on that research; and

processed staff report through the Zoning Administrator, the

Office of the County Attorney, the Planning Commission, and

ultimately to the Board of County Commissioners as a public

hearing. Responsible for answering all questions regarding

zoning changes at public hearings.

Sarasota County 2050 Regulations*, Sarasota

County, Florida

Project Manager responsible for the development of

accompanying Zoning Ordinance and Land Development

Regulations designed to implement the adopted

Comprehensive Plan policies relating to the development of

2050 Villages, Hamlets, and Settlements in Sarasota County.

These regulations incorporated the development and design

regulations for all parcels identified for future development as

designated on the Future Land Use map as a result of the 2050

Comprehensive Plan Amendment. Responsible for team of

County planners as well as the organization of all meetings

with the private consultant, Sarasota County’s Development

Review Committee, private land use planners, attorneys, and

landowners to make certain that the regulations were

eventually adopted by the Board of County Commissioners.

Shelley E. Hamilton Senior Planner

* denotes projects completed with other firms

Sarasota County Zoning Ordinance Re-write*,

Sarasota County, Florida

Team member for the review and re-write of the Sarasota

County Zoning Ordinance, a document that had been in

existence for 27 years. Responsible for the re-write of the

“Intent” sections of the existing zone districts, responding to

the private sector requests to add or amend existing language,

and reviewing the new sections that were being written.

Following final adoption, responsible for leading the training

effort for all aspects of the community including internal

County departments, private planners and land use attorneys,

property owners, and the community at large.

Sarasota County Zoning Atlas Correction*, Sarasota

County, Florida

Project Manager responsible for working directly with the

Planning Director to complete an intensive Zoning Atlas map

correction project involving the research and corrections of

the entire Sarasota County Zoning Atlas collection (1,160 half

section maps). This necessitated the creation of new mylars for

each half section, the transfer of the correct zoning district

boundaries for each map, and the copying and recording of

each map. Also involved the thorough research of all rezone

approvals from the original creation of the maps (1975) to

make certain that all properties had the correct zoning

designation.

V.J

MANATEE COUNTYAUG 15 28

Board of County CornmdssionesWanate County

BOARD OF COUNTY COMMISSIONERS1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700Bradenton, FL 34205 Fax: (941) 745-3790www.mymanatee.org/advisory_boards

APPLICATION forADVISORY BOARDICOMMITTEEICOMMISSION

PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? Name of Advisory Board:A separate application is required for each advisoryboard. Planning Commission

Some advisory board positions have specific Please specify the seat you are interested in:requirements for applicants. For more informationplease click on this link to the Manatee County websiteat: www.mymanatee.org/advisory_boards.

Name Howard Hammerman

Home StreetAddress 6855 Wagon Wheel CircleHome Mailing Address sameCity, State, Zip Sarasota, FL 34243Home Phone Work Phone Cell Phone 4104303019Email address howard@hammerman.comOccupation (if retired, please indicate) retiredBusiness name

Business street address

City, State, Zip

Are you registered to vote in Manatee County? Yes No 0(This is a requirement of certain boards/commissions)

I reside in County Commission District # 1 0 2 0 30 4 0 5 G(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No 0If No, please indicate the City

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boardslcommitteeslcommisslons.Providing this information will help Manatee County compile information needed to comply with the reporting requirement In Florid. State Statute 760.80.

Gender Male ® Female 0Race

African American 0 Asian American 0 Caucasian €JHispanic American 0 Native American 0 Other 0

Application Form 2016 1

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Mote Ranch Betterment Committee

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previouslyserved (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

I taught City Planning at Cornell University from 1972 to 1977. After that, I worked at the Dept. ofHousing and Urban Development in Washington, DC where I helped do the research which led to thesection 8 housing voucher program. I want to apply the expertise I’ve learned over the years to thecommunity I live in and make it a better place.

Describe your education and experience that will provide a benefit to this Advisory Board.

Ph.D. in Sociology with an emphasis on statistical analysis, model building and planning.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Member, Mote Ranch Betterment CommitteeVolunteer, United Way

Do you or your immediate family members have or hold any employment or contractual relationship withany business entity or agency which does business with or receives funding from Manatee CountyGovernment? Yes 0 No J If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemedas a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to servedue to job or travel? Yes Q No If yes, please explain.

Application Form 2016 2

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on theapplication but you may include extra pages to provide additional information. Applications will not be processed unlesseach section has been completed and all supplemental information sought by County staff has been provided.Applicants will not be permitted to change information on their submitted application materials once they have beenreceived by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for theapplicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board — page 4Healthcare Advisory Board — page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applyingand certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. Iunderstand that I am offering my service without compensation. I agree to abide by all Manatee County Commissionrules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I furtherhereby acknowledge that should my professional, residential or other status change subsequent to my appointmentto this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to theextent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is trueand complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Howard Hammerman Date 8/13/2018

Your application may be mailed to the address below. You may also fax or email your application, as follows:Mail: Board of County Commissioners Fax: 941-745-3790

1112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and thenATTN: Advisory Boards attach it to an email. Email to this address:Bradenton, FL 34205 advisoryboardsmymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basisof any individual’s disability status. This non-discrimination policy involves every aspect of theBoard’s functions including one’s access to, participation, employment, or treatment in its programsor activities. Anyone requiring reasonable accommodation for meetings as provided for in theAmericans with Disabilities Act should contact the Citizens Action Center, three days before a meetingat 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 3

Howard M. Hammerman, Ph.D.6855 Wagon Wheel CircleSarasota, FL 34243Home: 410-430-3019Email: howard@hammerman.comWeb site: www.hamrnerman.com

SUMMARY

More than 45 years professional experience conducting and managing information managementand research projects. Analytical accomplishments. Expertise in policy analysis, organizationaldevelopment, and statistics.

WORK EXPERIENCE:

President, Hammerman Associates, Sarasota, FL (1989 to present).

Principal consultant, Chief Technology Officer and trainer for Hamrnerman Associates, Inc., atraining, development and consulting firm specializing in business intelligence programs. Wrotefourteen manuals on the use of Crystal Reports, R&R Report Writer and other intelligencesoftware products. Created training manuals, videos and interactive CBTs. Trained other trainers.Conducted training seminars throughout North and South America. Developed commercialsoftware for clients in healthcare, hospitality, US Government, telecommunications, orderfulfillment, and mapping industries. Developed data warehouse software.

Personally trained more than 2000 people on the use of Crystal Reports and R&R Report Writersoftware throughout North America.

Supported more than 300 hotels in the use of the Springer-Miller HOST PMS as it pertains toextracting useful management reports.

Featured speaker at Crystal Reports Users Conferences.

Prior Work Experience:

Graduate School, University College, University of Maryland 1988-1989In charge of creating a consulting arm of the graduate school. Solicited clients and wrote proposalsfor several government and non-government clients.

KeyData Systems, Greenbelt Maryland, 1986-1988Program manager. In charge of a four-person software development group that created applicationsfor the Environmental Protection Agency, the FBI, and the Federal Emergency ManagementAgency. Installed and managed the firm’s internal network.

Dept. Of Housing and Urban Development, Washington, DC, 1977 - 1985Social Science Analyst. Managed more than $60 million in research projects for the Office ofPolicy, Planning and Development. Wrote RFPs and chaired selection committees. Wrotenumerous analytical reports and responded to congressional requests for information.

Cornell University, 1972 - 1977Assistant Professor, Department of City and Regional Planning. Taught courses in city planning,statistics, survey research, gaming theory, and Sociology. Advised graduate students and conductedcommunity surveys. Developed gaming simulation exercises.

EDUCATION

Ph.D. - Sociology, University of Michigan, Ann Arbor, MI., 1974BA - Sociology, Antioch College, Yellow Springs, OH, 1966

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700 Bradenton, FL 34205 Fax: (941) 745-3790 www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

Planning Commission

Jedd W. Heap, AIA

3906 15th Ave W

Bradenton, FL 34205941-404-8055 x3 941-518-8021

jedd@leaderdesignstudio.comArchitect

Leader Design Studio1003 N. Orange Ave

Sarasota, FL 34236

Application Form 2016 2

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

City of Bradenton Affordable Housing Committee

Manatee County 14th CRA Advisor Board, +/- 2007-2011

To help design/build a better community by offering my expertise and outside the box thinking.

BA Architecture 1998, UFMA Architecture 2006, USF

Florida Lic. ArchitectUSGBC, LEED AP BD+C

AIA National, Young Architect (FL Region)AIA Florida, BODAIA Gulf Coast, BOD (Director, Sec., VP, President)CSI Suncoast, BOD (Director, VP, President)Realize Bradenton, BOD

Application Form 201 3

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

NA

Jedd W. Heap, AIA 05/21/18

Application Form 201 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

Big Brothers/Big Sisters of the Sun oast Boys & Girls Clubs Centerstone

Early Learning Coalition of Manatee County Easter Seals Educational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources

Foundation for Dreams Hope Family Services

anatee Children’s Services, Inc.Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus Myakka City Community Center Pace Center for Girls Palmetto Youth Center

Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah FreedomTallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 201 5

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

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Ø Ù Ú Û Û Ü Ý Þ Ú ß Ý à Ù ß à ß á â ÷ â Ú Ü ß á Þ Ú æ â Ø ã ä Ý å à æ ç è à Ú æ ã æ â é ê Ý æ â å Ú æ â å ê ë â à æÞ ê æ æ Ý Þ ê Ü ê ë ä Ý ß Ú â ì í á Ý Þ á ë Ú ç î â â ë Ú Ý Ü â ã Ú Ü à Ù ï í Ý ß á ç à ê æ Ú Û Û Ü Ý Þ Ú ß Ý à Ù ß àÚ ã ä Ý å à æ ç î à Ú æ ã å ð ë ç ë Ú Ù Ú ß â â ñ à æ ï ì à æ ë Ú ç î â ë Ú Ý Ü â ã à æ ò Ú ó â ã ß à ô Ú Ù Ú ß â â õ à ê Ù ß ç Ú ß ß á â Ú ã ã æ â å å Ú Ù ãò Ú ó Ù ê ë î â æ Û æ à ä Ý ã â ã à Ù Û Ú ï â ö ñ

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

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Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? Yes No (This is a requirement of certain boards/commissions)

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race

African American Asian American Caucasian

Hispanic American Native American Other _______________________

Application Form 2016 1

Planning Commission

Gregory Lowell Janssen

16023 Topsail Terrace

Lakewood Ranch, FL 34202941 362-2948 941 362-2948 239 298-6706gjpjindia@hotmail.com

Small Business Owner and Retired (after 41 years) From Caterpillar Inc.

GJPJ Hopldings LLC

16023 Topsail Terrace

Lakewood Ranch, FL 34202

Lakewood Ranch

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Application Form 2016 2

None currently, I have served on a planning commission in Pennslyvania (Marshall Township in Allegheny County).

None

As a full time resident and business owner in Manatee County, I want to have a say and role in how this beautiful place is developed and grows aith an eye towards sustainable growth and balance of maintaining the natural beauty of this county and region.

I have a BS in Management and an MPM (Master in Public Management) from Carnegie Mellen University. I worked for Caterpillar Inc in several roles progressing to Director of Global Logistics. I am a honorably discharged veteran of the US Air Force and Illinois National Guard. Active Duty from 1975-1978 and National Guard from 1978-1983. I have lived in India and Singapore while working for Cagterpillar and conducted business in over 100 countries. As a small business owner (my wife and I own 6 Hair salons in the area including 2 in Manatee County) we plan on being a part of the success of the county for years to come. We currently employee 30 people and have $1.2 Million in annual sales.

Manatee Chamber of Commerce

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage. 2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information. 3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal. 4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of this statute, please explain: _________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, review permit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereign powers and members are prohibited by Florida law from holding more than one such position. If you currently hold another state, municipal or county government appointment, County staff will assist in confirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the

extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. You may also fax or email your application, as follows: Mail: Board of County Commissioners Fax: 941-745-3790

1112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and then ATTN: Advisory Boards attach it to an email. Email to this address: Bradenton, FL 34205 advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs

or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 3

Gregory Lowell Janssen 8/24/2018

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; or contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc. Insight Counseling Services

Big Brothers/Big Sisters of the Suncoast Manatee Children’s Services, Inc.

Boys & Girls Clubs of Manatee Manatee County Girls Club (Just for Girls) Centers for Success (Tallevast Comm Ctr) Meals on Wheels Plus of Manatee

Centerstone of Florida Myakka City Community Center Community Coalition for Youth (New Path) Pace Center for Girls D.L. Randall Foundation Palmetto Youth Center Early Learning Coalition of Manatee County Replay Outreach

Easter Seals of SW Florida Sarasota Family YMCA Educational Consultants Consortium Sarasota Manatee Assn. Riding Therapy Exchange Club Parenting Matters School District of Manatee County Family Network on Disabilities Selah Freedom, Inc. Family Resources Step Up Suncoast (MCAA) Feeding Empty Little Tummies The Salvation Army Foundation for Dreams United Community Centers

Hope Family Services

Please explain the affiliation you have with the above agencies:

An application to the Children's Services Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 2018 4

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 2017 5

MANATEE COUNTY / 2O

BOARD OF COUNTY COMM1SSIONEIotCcuryuiinrs

1 12 Mana’e \ iiuc Vt’est,Sahe ? Phtne: (94!) -7tJ1Bud:aoti, FL 342d Fax: (94!) dS-379O

u?!; u’ r

i’ • -iQi

ADVSORY 3OARD!(OMMTTh!COMMPSSONPLEASE 1’,PE OR PRINT IN INK

or wh!ch Advisory Board are you applying? N n’ of Advisory Board:A seporale apphcation is required for each advisoryboard. (%-U{1Sfjvr

Some advisory board positions have soecific Please specif the seat you are interested in:requirements for applicants. For more information V

please click on this link to the Manatee County NtDSite

at: www.rnymanatee.org/advisoryhoards.

________ _________________________________

Name__JOIT’____

________________

Home Street Address /65t_______________________________

_______________

Home Mailing Address

Cell Phone

EmaU address ,/eL.i/u e%C

V

Ccpaniw pledse dicte) 5,

___________ __________

6uainess street address ///v

_____/ ______ ______

City, State, Zip ,t7j1/ L

_________________________________

Are you registered t vote in Manatee County?‘

(This is a requirement of certain boards/commissions)

_____________________________________ ______

I reside in County Commission District # 1 2 (I 3 () 4 Q 5 •(This can be found on your ‘Joter Reqistratn Card or CL: or; th ir 0 2 Oo.!nly Csrnciis;on District Map)

Do you resde in unincorporated Mana’ee County? a

If No, please indicate the C!ty

________ _____ _________________________________

Tile Board of County Commissioners stri’,es to ensure cqusl accs,- far 1 irOHtS sncf colu’r to rare 01 advisory boardslcommittees/commissiorieProvidinq this information will help Manatee County compia .910 rro;ion oad to c requirement in Florida State Statute 760.80.

Gender—________

Race

A!iicar Arnericau () Af*r A:d tn :E) C.eLcSn

Hpanc Amedcan NaUve Anei-;ai 1.J Cñer (.

AppliCation Form 2016

Pasest any govemrnent Advisory Boards/Corn rnittees/Cornrniss!ors on wch you currentiy serve.

Please list any Manatee County Advisori BoardsiCornrnittees/C3mmissions on which you have prevousiy

served (include dates of your service).

Why do you want to serve on this Advisor;’ Board or Committee?

i’) jcL % cii4

:Descrie your education and experience that will provide a benefit to this Advisory Board.

6%i a/et4,i,i,1a/6ñ; 4/6,

“57t 116 J4J’?h 44List ycu poessori) cedenua, or certs th aie ie’an t DOarLIT,

//%‘ /‘,‘j (eWJifl4’

‘2 jr

AlE 7DV 1 ip2;

List organizations and positions in which you sane in loca civic or community groups.

,&‘L/t/6 /-1Z y

Do you or your immediate family members have or hoid any employment or contractual relationship with

any business entity or agency which does business with or receives funding from Manatee County

Government? Yes 0 No lf yes, piease explain.

Do you know of any other reason that wouid prohibit you from serving on this board that couid be ceemed

as a conflict of interest? Q No f :‘es ptnase ex’ain.

you are appointed, are there any days of the week oc months of the year you wW be UnCVaIICh :o serve

due to job or travel? Yes 0’ No : If yes, please explain.

Apoiation Form 2016

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.

2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.

3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of this

statute, please explain:

5. Advisory boards, committees or commissions having the authority to make factual determinations, review

permit applications, issue permits. grant variances, or impose fines exercise a part of the County’s sovereign

powers and members are prohibited by Florida law from holding more than one such position. If you

currently hold another state, municipal or county government appointment, County staff will assist in

confirming your eligibility to serve on the board for which yau are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on the

application but you may include extra pages to provide additional information. Applications will not be processed unless

each section has been completed and all supplemental information sought by County staff has been provided.

Apphcants will not be permitted to change information on their submitted application materials once they have been

received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the

applicant to be considered for appontment. See pages 4 nd 5 of this form.

Children’s Services Advisory Board — page 4Healthcare Advisory Board — page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying

and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibi!ities. I

understand that I am offering my service without compensation. I agree to anide by all Manatee County Commission

rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further

hereby acknowledge that should my professional, residential or other status change subsequent to my appointment

to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the

extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that ihe in ormation provided in this application is true

and complete, and this constitutes my signature under the Fprida , tronic Signature Act.

Electronic Signature Type or Si_____ Date

Your application may be mailed to the address below. You may also fax or email your application, as follows:

Mail: Board of County Commissioners Fax: 941-745-37901112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and thenATTN: Advisory Boards attach it to an email. Email to this address:Bradenton, FL 34205 advisoryboardsmyrnanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis

of any individual’s disability status. This non-discrimination riolicy involves every aspect of the

Board’s functions incuding one’s access to, particpeton. employment, or treatment in its programs

or activities. Anyone requiring reasonable accommodation for meetings as provided for in the

Americans with Disabilities Act shoud contact the Citizens Action Center, three days before a meeting

at 742-5800; TDD ONLY 742-5802 and wait 0 seconds; or FAX 745-3790.

Application Form 2017

RECEIVED 6694 41st Street — Circle E

AUG 2 B 2018 Sarasota, FL 34243

Coun ComISSOfltanaLeeCounty ugust

Board of County Commissioners

1112 Manatee Avenue West, Suite 902

ATTN: Advisory Boards

Bradenton, FL 34205

Dear Sirs:

I am applying to become a member of the Manatee County Planning Commission.I was very active in the Town of Burlington, MA as a member of the PlanningBoard for 12 years (1976 — 1988) and a Town Engineer of the same Town for 13years (1988— 2001). I was a resident of the Town of Burlington, MA from 1970 to2010. I have been a resident of Manatee County since 2010.

I am a graduate of the University of Pittsburgh with a Bachelor of Science in CivilEngineer. I was registered as a Professional Engineer in Pennsylvania, Ohio andMassachusetts. I am still registered in Massachusetts as a P.E.

As a member of the Planning Board in Burlington, we reviewed applications forsite plans and various subdivisions. I still have an interest in Planning Board issues.

Pete G. Peters

MANATEE COUNTYBOARD OF COUNTY COMMISSIONERS1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700Bradenton, FL 34205 Fax: (941) 745-3790www.mymanatee.org/advisory_boards

APPLICATION forADVISORY BOARDICOMMITTEEICOMMISSION

PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? Name of Advisory Board:A separate application is required for each advisory Manatee County Planning Commissionboard.

Some advisory board positions have specific Please specify the seat you are interested in:requirements for applicants. For more information Planning Commission Memberplease click on this link to the Manatee County websiteat: www.mymanatee.org/advisory_boards.

Name Pete G. Peters

Home Street Address 6694 41 st Street - Circle E

Home Mailing Address

City, State, Zip Sarasota, FL 34243Home Phone Work Phone Cell Phone 941 -404-0852Email address pgpetersl 939@hotmail.comOccupation (if retired, please indicate) Civil Engineer - Registered as a PE

Business name

Business street address

City, State, Zip

Are you registered to vote in Manatee County? Yes ® No 0(This is a requirement of certain boards/commissions)

I reside in County Commission District if 1 0 2 0 3 0 4 ® 5 0(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes 0 No 0If No, please indicate the City

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boardslcommltteesicommissions.Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female 0Race

African American 0 Asian American 0 Caucasian ®Hispanic American 0 Native American 0 Other 0

Application Form 2016 I

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previouslyserved (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?As a member of this community and from my prior experience, I feel that I can participate on the Planning Commission for ManateeCounty.

Describe your education and experience that will provide a benefit to this Advisory Board.I am a Graduate of the University of Pittsburgh, Pittsburgh, PA with a Bachelor of Science in Civil Engineering. I am a RegisteredProfessional Engineer in the State of Massachusetts. I have served for 12 years on the Planning Board in Burlington, MA and 13years as a Town Engineer in Burlington, MA.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.Registered as a Professional Engineer in the State of Massachusetts.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship withany business entity or agency which does business with or receives funding from Manatee CountyGovernment? Yes 0 No ® If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemedas a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to servedue to job or travel? Yes 0 No If yes, please explain.

Application Form 2016 2

IMPORTANT INFORMATION1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

rem oval.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICEApplications must be complete and signed to be valid. Resumes may not be substituted for the sections on theapplication but you may include extra pages to provide additional information. Applications will not be processed unlesseach section has been completed and all supplemental information sought by County staff has been provided.Applicants will not be permitted to change information on their submitted application materials once they have beenreceived by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for theapplicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board — page 4Healthcare Advisory Board — page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applyingand certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. Iunderstand that I am offering my service without compensation. I agree to abide by all Manatee County Commissionrules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I furtherhereby acknowledge that should my professional, residential or other status change subsequent to my appointmentto this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to theextent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is trueand complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. You may also fax or email your application, as follows:

Mail: Board of County Commissioners Fax: 941-745-37901112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and thenATTN: Advisory Boards attach it to an email. Email to this address:Bradenton, FL 34205 advisoryboardsmymanatee org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basisof any individual’s disability status. This non-discrimination policy involves every aspect of theBoard’s functions including one’s access to, participation, employment, or treatment in its programsor activities. Anyone requiring reasonable accommodation for meetings as provided for in theAmericans with Disabilities Act should contact the Citizens Action Center, three days before a meetingat 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 2017 3

Supplemental Questions for Applicants to the Manatee CountyChildren’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from ManateeCounty? Affiliated means: an employee of the agency; owner of the agency; voting member on theagency’s Board of Directors; or contract with the agency.

Yes 0 N0G

If yes, please select the agency from the list below. Check all that apply:

El AMikids Manatee, Inc.

El Big Brothers/Big Sisters of the Suncoast

El Boys & Girls Clubs of Manatee

El Centers for Success (Tallevast Comm Ctr)

El Centerstone of Florida

El Community Coalition for Youth (New Path)

El D.L. Randall Foundation

El Early Learning Coalition of Manatee County

El Easter Seals of SW Florida

El Educational Consultants Consortium

El Exchange Club Parenting Matters

Family Network on Disabilities

El Family Resources

[] Feeding Empty Little Tummies

El Foundation for Dreams

El Hope Family Services

El Insight Counseling Services

El Manatee Children’s Services, Inc.

El Manatee County Girls Club (Just for Girls)

El Meals on Wheels Plus of Manatee

LI Myakka City Community Center

El Pace Center for Girls

El Palmetto Youth Center

El Replay Outreach

El Sarasota Family YMCA

El Sarasota Manatee Assn. Riding Therapy

School District of Manatee County

ElSelah Freedom, Inc.

El Step Up Suncoast (MCAA)

ElThe Salvation Army

El United Community Centers

Please explain the affiliation you have with the above agencies:

An application to the Children’s Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application toadvisorvboards(mymanatee.org, or may be mailed or faxed to Manatee County at the address andfax number provided on page 3.

Application Form 2018 4

Supplemental Questions for Applicants to the Manatee CountyHealthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

fl Healthcare

I:i Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

IEI Higher Education

Medically Needy Consumer of Healthcare

LI Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency thatreceives funding from Manatee County directly or indirectly? Yes 0 No 0If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives orcommittees (e.g: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

YesQ NoCIf yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume orcurriculum vitae, which may be emailed along with your application toadvisorvboards(mymanatee.org, or may be mailed or faxed to Manatee County at the address andfax number provided on page 3.

Application Form 2017 5

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip

Are you registered to vote in Manatee County? Yes No (This is a requirement of certain boards/commissions)

I reside in County Commission District # 1 2 3 4 5

(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions.

Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female

Race

African American Asian American Caucasian

Hispanic American Native American Other _______________________

Application Form 2016 1

Planning Commission� � � � � � � � � � � � � � � �John L. Simon

� � � � � � � � �14809 17th Ave E

� � � � � � � � � � � � �Same

� � � �Bradenton

� � � � � � � � �2483465375

� � � � � � � � Js411215@gmail.com � � � � � ! � � � � � " � �

Retired# � � � � � �

Bradenton� � � � � � � � �

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve.

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Application Form 2016 2

None$ � � �None$ � � �It is an area of professional and personal interest.% � � � � � � � � � & ' � � & � � � � � � � � � ' � � � � � � � � � � � � � High School graduate with 3 years of college pursuing a Civil Engineering degree. Worked with a Planning and Engineering company for 9 years providing transportation planning consulting services for a multitude of major and minor projects. During the ensuing 30 years, I worked with major real estate development companies directing the development of virtually all forms or land uses in the US and abroad. (See attached summary resume).

( � � � � " � � � � � � � � ) � � � * � � � � + � � � � & " � � � � � � ' ) � ) � � � � � � � � � � � � � � � � � � � � � � � � � � , � � - � � * � � � �� � � � � � � � � � � � � � � � � � � � � � " � � ' � � + & � � � + � � � ' � � � � � � � � � � � � ' � � � � � � � � ' � � � � � � � " � � ) � � � � � � � � � " � & � � � � ) � � � � ) � � � & � � . � � � � � � � � � � ' � � . � " � / ) � � � � � � � � � ) � � � � � + � � � 0 % * � � - � � * � � �� � . � � � � � � � � � � � � � � � � � ' � � � � " � � ' � � � � � � � � " � � � � � � � � � � � � � ' � � � � � & � � � � ) � � � + � � � & � � � � � � � � �� � � 1 � � 2 � 3 � � � � � 4Former member of the Institute of Transportation Engineers, International Council of Shopping Centers, The Urban Land Institute, and served on a transportation committee of the National Academy of Sciences.

5 � � � � � � � � 2 � � � & � � � % � � � � ) � � � & 6 � � � ' � � � � � � � � � � � � � � � � 0 % � � � � � � � � � � � � � � ) � " � � � & � � � ' ' � � �� � � � � � 0 6 � � 1 � 2 � � � � � � % � � � � ) � � 0 � � � � � � � � � � � � � � � ' � � � � � � � � " � � � � � � � � � & � � � $ � � � � � � �� " � � � � + � & � " � � � " � None$ � � �

Occasional vacations of 2-3weeks in duration7 " " � � � � � � � � " � � � � � � & � 8 � * � � - � � � ) � � � � � �

IMPORTANT INFORMATION

1. For questions regarding a specific advisory board, committee, or commission, including the duties and requirements, please contact the County staff liaison 9 : ; < = > ? @ < A B < C ? B D > E ; F = C G B H = I

2. Certain advisory boards, committees, and commissions have specific membership requirements including a valid voter registration card, financial disclosure and/or the submission of other information.

3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for removal.

4. Florida State Statute 119.07 designates this application as a public document to be made available for anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of this statute, please explain: _________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, review G = D J : < B G G 9 : K B < : ? @ ; L : ; ; M = G = D J : < ; L H D B @ < N B D : B @ K = ; L ? D : J G ? ; = O : @ = ; = P = D K : ; = B G B D < ? O < A = Q ? M @ < R E ; ; ? N = D = : H @

powers and members are prohibited by Florida law from holding more than one such position. If you currently hold another state, municipal or county government appointment, County staff will assist in confirming your eligibility to serve on the board for which you are applying.

NOTICE

Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form. S T U V W X Y Z [ \ ] Y X ^ U _ Y \ ` W ^ U \ a X b c a d X W

e

page 4 Healthcare Advisory Board e

page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying

and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I

understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission

rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further

hereby acknowledge that should my professional, residential or other status change subsequent to my appointment < ? < A : ; C ? B D > ? D K ? J J : ; ; : ? @ L f A B N = B K ? @ < : @ M : @ H ? C 9 : H B < : ? @ < ? : @ O ? D J < A = Q ? M @ < R E ; ; < B O O 9 : B : ; ? @ ? O < A B < K A B @ H = < ? < A =extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true

and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. You may also fax or email your application, as follows:

Mail: Board of County Commissioners Fax: 941-745-3790 1112 Manatee Avenue West, Suite 902 Email: Save this pdf form to your computer and then ATTN: Advisory Boards attach it to an email. Email to this address: Bradenton, FL 34205 advisoryboards@mymanatee.org

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis a g

d Z b

U Z W U ^ U W h d V [ \ W U \ d i U V U j b \ j d j h \ k l T U \ Z a Z

-discrimination policy involves every aspect of the c a d X W [ \ g h Z _ j U a Z \

U Z _ V h W U Z m

a Z Y [ \

d _ _ Y \ \ j a n o d X j U _ U o d j U a Z n Y p o V a b p Y Z j n a X

j X Y d j p Y Z j

U Z U j \ o X a m X d p \or activities. Anyone requiring reasonable accommodation for meetings as provided for in the

Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting

at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Application Form 201 3

� � � � � � � � � � � q � q � � � �

Supplemental Questions for Applicants to the Manatee County Advisory Board

Please complete all questions with current and accurate information. r s t u v w x y y z { z x | t } ~ z | � x � u x � t � � u | � x | s t � t z � t � � � z { } s t � � � � t s � z � t � } t } z � x | t } � z { { x � t yunds from Manatee � v w � | u � r y y z { z x | t } � t x � � � x � t � � { v u t t v y | � t x � t � � u � v ~ � t s v y | � t x � t � � u � � v | z � � � t � � t s v � | � tx � t � � u � �

Board of Directors; contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

Big Brothers/Big Sisters of the Sun oast x � x | t t � � z { } s t � � � � t s � z � t � � � � � �

Boys & Girls Clubs Manatee County Girls Club (Just for Girls)

Centers Meals on Wheels Plus

Myakka City Community Center

Pace Center for Girls

Palmetto Youth Center

Early Learning Coalition of Manatee County

Easter Seals

Educational Consultants Consortium Sarasota Manatee Assn. Riding Therapy

Exchange Club Par School District of Manatee County

Family Network on Disabilities Selah Freedom

Family Resources

The Salvation Army

Foundation for Dreams United Community Center

Hope Family Services

Please explain the affiliation you have with the above agencies:

An application to the Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 201 4

Supplemental Questions for Applicants to the Manatee County Healthcare Advisory Board.

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.: Health Care Alliance, Chamber Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to advisoryboards@mymanatee.org, or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Application Form 201 5

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Planning Commission Advisory Board – Candidate Matrix

Choose Two (3)

Commission District

Applicant Profession Education/Experience/Employment/ Potential Conflicts

Current Advisory

Board Member

4 James P. Adkins

Real Estate & Construction

Licensed Real Estate Broker & Residential Contractor. Owner of development company and property management company.

No

1 Amanda Barbee

Landscape Architect

Bachelor of Landscape Architecture, CLARB – Council of Landscape Architectural Registration Board / 4 years working with locate agencies and developers / Employer – Gause and Associates, Inc. / Potential Conflict – Gause and Associates, Inc. prepares plans which are processed for site plan approvals with Manatee county, Additionally, they serve as a sub-consultant to other firms providing services to Manatee County Property Management.

No

4 Mark Black Retired Master’s Degree in Public Administration and 20+ construction code related certifications from

International Code Council/30+ years in construction industry as business owner and code

official.

No

3 Matthew J. Bower

Financial Advisor, Edward Jones

BA – Business Administration, AAMS, 4 years on Manatee County Planning Commission

No

3 Kent N. Brown

Retired US Diplomat – Advised governments on policies necessary to achieve the rule of law and economic development/ Rank of Ambassador to developing country

No

5 Richard A. Buchanan

Retired BS in Naval Engineering, Masters Business Administration / Nuclear Submarine Officer 31 years / 5 years business development with First National Bank of Omaha / President of Navy Memorial Foundation / Retired as director of Strategic Planning for Veteran’s Benefits Administration. / Advisory Council of ThanksUSA / Landscape committee of Tidewater Preserve HOA / previous President of falls gate Homeowners Association. Potential Conflict – Wife works part time for Florida Department of Health Manatee County.

No

3 Craig Copeman

Real Estate Sales Licensed Florida Real Estate broker; sold homes, businesses, developed land and worked closely with Planning Department for many years representing clients needs in relationship to the Land Development Code.

No

3 Jonathan B. Crane

Retired JD University South Cal. Law Center; BA Journalism / Practiced law / Chairman, Anna Maria Planning & Zoning Board

No

5 Peter G. DeAngelis

Retired Bachelor of Arts / Councilman Akron, Ohio / Independent Insurance Owner

No

1 John DeLesline

General Contractor

Current Planning Commission member for Manatee County / Licensed General Contractor

Yes Attendance

92%

1 Steven Dennis

Commercial Real Estate Sales

MBA / Real Estate Broker No

4 Glen Gibellina

Retired Boots on the ground activist; engaged with local Government along with State and Federal Government / Retired Certified General Contractor

No

5 Shelley Hamilton

Planner 35 years Planning Experience as planner for local Governments and private firm / Previous member of Board of Zoning Appeals for City of Palmetto Potential Conflict: as employee of a firm that submits applications for consideration by the Planning Commission may have to abstain from time to time for applications her company represents.

No

5 Howard Hammerman

Retired Ph.D. in Sociology with emphasis on statistical analysis, model building and planning.

No

3 Jedd W. Heap, AIA

Architect BA and MA Architecture / Florida Licensed Architect / USGBC, LEED AP BD&C

No

4 John E. Howell

Multimedia Editor

Editor Sarasota Herald Tribune No

5 Gregory Lowell

Janssen

Retired / Small Business Owner

BS Management, MPM (Master in Public Management), Veteran of Air Force and Illinois National Guard

No

5 John T. Kleban

Semi-retired / Business Professor

BSME (Mechanical Eng.); MBA; Small Business Owner

No

5 Lillian Fay Lipson

Retired Nursing; Pharmaceutical Industry as Clinical Research Associate and senior Clinical Trials Monitor

No

4 Pete G. Peters

Civil Engineer – Registered as a

PE

Bachelor of science in Civil Engineering/ Planning Board Experience in MA / Professional Engineer

No

5 John L. Simon

Retired Planning and Engineering Experience; Transportation Planning Consulting

No

5 William W. Smock

Plumbing Contractor

AA Business Administration/ Construction Industry / Master Plumbing License / Builder’s License

No

5 Andrea L. Suarez

Office Manager Undergrad USF; Board Member Master’s Association Palmer Ranch

No

3 Jason B. Taylor

Architect/Interior Designer

Bachelor of Fine Arts; Master of Architecture; Previous City of Bradenton Planning Commission and Architectural Review Board / Licensed Architect and Interior Designer, LEEP AP BD+C

No

Current Membership Roster

Member Term expires Bill Conerly October 2019

Mike Rahn October 2020

Paul Rutledge October 2020

David Roth October 2021

John DeLesline October 2018 (asking for reappointment)

Vacant Seat

Vacant Seat

IF YOU WISH TO ADDRESS THE BOARD DURING A

PUBLIC HEARING ON TODAY'S AGENDA, PLEASE

COMPLETE THIS FORM . THANK YOU.

Individuals wishing to speak on any Public Hearing matter must indicate so by filling out this form and return ing it to the Clerk prior to the beginning of the Public Hearing.

PLEASE PRINT

Name ) AvVfS /X()'-( IJ:P

Address G-fJl ( ~~ .(L_ ?-1=/V £0

Phone (Optional) _____________ _

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Representi ng _______________ _

1.

* '

Optional : Are you in favor :

opposed :

Designation in favor or opposed is required solely for determination of the order of appearance. The number of people for or against a matter is not considered by the Board with regard to whether to approve or deny the matter.

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28. If you are speaking as an official representative of a

group: **

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You are required to provide the Clerk with written evidence of your authority to speak on behalf of the organization or group you represent for land use public hearings.

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